Transmembrane Potential Properties at the Core of Functional Reentrant Wave Fronts in Isolated Canine Right Atria

Abstract

Background —The characteristics of transmembrane potential (TMP) at the core of functional reentry in the atrium are not well understood. Methods and Results —In protocol 1 (11 dogs), isolated perfused canine right atria were mapped from the endocardial surface while simultaneous TMPs were recorded from the epicardial surface. Episodes of reentry (n=64) were induced in the presence of 1 to 5 μmol/L acetylcholine. Successful simultaneous TMP recordings and activation maps were made in 8 episodes. The TMP was “near the core” if it was within 3.2 mm of the core; otherwise, it was considered to be “in the periphery.” The mean cycle length of reentry was 110±35 ms. The TMP amplitude, duration (90% repolarization), and (dV/dt) max near the core (n=106) were 58±22 mV, 46±14 ms, and 33±20 V/s, respectively, significantly less than those in the periphery (n=241): 70±8 mV, 94±32 ms, and 55±10 V/s ( P <0.001 for all). In 2 episodes of reentry, the cell at the core remained unexcited at its resting membrane potential. In protocol 2 (2 dogs), we performed simultaneous high-density mapping in 4 episodes of reentry and showed synchronous activation patterns on both surfaces with similar locations of the core. Conclusions —During meandering functional reentry in isolated canine right atria, (1) TMPs of cells near the core have a reduced amplitude, duration, and (dV/dt) max , and (2) cells at the core may remain unexcited at their resting membrane potential. These findings are compatible with the spiral wave concept of functional reentry in the atrium.